HomeMy WebLinkAboutMortgage_Penner �"'4s STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
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�s= FOR DEDUCTION FROM ASSESSED VALUATION Gibson 0 a(o 2022
:, State Form 43709(R14/1-20)
S�a �� Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: To be filed in person or by mail. Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. 0 County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property
is located on or before January 5 of the calendar year in which the property taxes are first due and payable. 0 County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Quincy Penner
Taxing District Key number/legal description Record number Page number
Fort Branch 26-18-24-202-000.284-026/MCCRARY ETAL 74PT/79PT Z 2 `
O 2_. 5-5 l
Assessed value of real property as of Mortgage I Contract indebtedness unpaid as of Mortgage/Contract Indebtedness unpaid as of Is the applicant the sole
as�eament date,current year assessment date,current year date of application I�al ior equitable owner?
$0.00 $333,841.00 XJ Yes ❑No
If no,what is his/her exact share of interest? iLED
owned with someone other than spouse,indicate with whom
If name on record is dd F
rent than that of applicant,indicate below: thReale propertyProperty in question:AnnuallyAnnually Assessed
� Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Mortgage Masters of Indiana,Inc. AV 2 3 2022
Address of mortgagee or contract seller(number and street,city,state,and ZIP code
501 N.Cross Pointe Blvd.,Evansville, IN 47715
Name of assignee or other owner or holder of mortgage k t1_ . __/ a
Address of assignee(number and street city,state,and ZIP code)
GIBSON COUNTY Atlf %TOR
Does applicant own property in any If yes,what county? What Taxing District? Has this deductio en requested If yes,state amount of deduction
other county on property for Yes No
in Indiana? 0 Yes 0 No current year?
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or on ct indebtedness that is recorded in the county
recorder's office(including any home equity line of credit that is recorded in the county recorder's office)tha is the basis for the deduction.
COUNTY AUDITOR
Deduction approved In the amount of:
20 20 20 20 20 20 20
Signature of County Auditor County Date(month,day,yeEl-
.A&-JL.,( 2,_--z___...,
U --- � v Gibson 5/"7
1/We certify under penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner!contract buyer of the aforementioned property on date application is filed_
n re(owners full me) Da nt/I,d y r)
,Jj1 r
Full r nt d p icam(number 7rd?beet,city,state,and ZIP code)
103 _Strain St}Branch, IN 47648
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person(number and street,city,state,and ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed S10,000.
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant Name of mortgagee or contract seller
Quincy Penner Mortgage Masters of Indiana,Inc.
Date fil (month,day,year) Amount of Indebtedness Taxing Distri D r�� T_��T
"/r9 y/ a $333,841.00 f- A<LG` ■ ■
Key number/legal description
26-18-24-202-000.284-026/MCCRARY ETAL 74PT/79PT
Signatuip of County Auditor/ContY Recorder County�f j Date(month U G year)
2022
/'u`Q/"/Jt/V1G�i��� Gibson �.y�� H G
GIBSON COUNTY AUDITOR